Analysis of quadríceps thickness and handgrip strength in hospitalized individuals: A cross-sectional study
DOI:
https://doi.org/10.33448/rsd-v14i12.49932Keywords:
Ultrasonography, Muscle Strength , Sarcopenia, Hospitalization, Chronic Disease.Abstract
Population aging and the increase in non-communicable chronic diseases have contributed to the occurrence of sarcopenia. This loss of muscle mass and strength is associated with worse clinical outcomes, such as functional disability, prolonged hospitalization, and higher mortality. The objective was to analyze and compare quadriceps muscle thickness and handgrip strength in hospitalized individuals with different chronic diseases. It is an observational, cross-sectional study conducted between August and December 2025, including 14 participants divided into two groups: chronic (n=7) and control (n=7). Quadriceps thickness was assessed by ultrasound (B-mode), and handgrip strength was measured using an electronic dynamometer. Data were analyzed using SPSS 25.0, applying Student’s t-test, Mann–Whitney test, chi-square test, and Fisher’s exact test, with p<0.05. The sample showed similar distribution by sex and age (p=0.08). The most prevalent diseases in the chronic group were chronic kidney disease and heart failure (57.1%). The mean length of hospital stay was longer in this group (12.7 ± 9.5 days) compared with the control group (5.6 ± 4.7 days; p=0.04). Lower quadriceps thickness (8.7 ± 2.2 mm vs 12.0 ± 2.4 mm; p=0.02) and reduced handgrip strength (21.9 ± 11.5 kgf vs 35.3 ± 10.9 kgf; p=0.03) were observed among chronic patients. In conclusion, hospitalized patients with chronic diseases showed significant reductions in muscle thickness and handgrip strength, indicating muscle impairment associated with clinical conditions and longer hospital stays.
References
Antuña, E., Cachán-Vega, C., Bermejo-Millo, J. C., Potes, Y., Caballero, B., Vega-Naredo, I., Coto-Montes, A., & Garcia-Gonzalez, C. (2022). Inflammaging: Implications in Sarcopenia. International Journal of Molecular Sciences, 23(23), 1–24. https://doi.org/10.3390/ijms232315039
Aryana, I. G. P. S., Hapsari, A. A. A. R., & Kuswardhani, R. A. T. (2018). Myokine Regulation as Marker of Sarcopenia in Elderly. Molecular and Cellular Biomedical Sciences, 2(2), 38–47. https://doi.org/10.21705/mcbs.v2i2.32
Costa, M. J. C., Cavalcanti, F. C. B., Bezerra, S. D., De Araújo Filho, J. C., Fernandes, J., & Marinho, P. E. M. (2022). Relationship between quadriceps thickness and 60-second sit-to-stand test in patients with chronic kidney disease. Brazilian Journal of Nephrology, 42(2), 164–170. https://doi.org/10.1590/2175-8239-JBN-2021-0064
Cruz-Jentoft, A. J., Bahat, G., Bauer, J., Boirie, Y., Bruyère, O., Cederholm, T., Cooper, C., Landi, F., Rolland, Y., Sayer, A. A., Schneider, S. M., Sieber, C. C., Topinkova, E., Vandewoude, M., Visser, M., Zamboni, M., Bautmans, I., Baeyens, J. P., Cesari, M., … Schols, J. (2019). Sarcopenia: Revised European consensus on definition and diagnosis. Age and Ageing, 48(1), 16–31. https://doi.org/10.1093/ageing/afy169
Ebner, N., Sliziuk, V., Scherbakov, N., & Sandek, A. (2015). Muscle wasting in ageing and chronic illness. 58–68. https://doi.org/10.1002/ehf2.12033
Einarson, T. R., Acs, A., Ludwig, C., & Panton, U. H. (2018). Prevalence of cardiovascular disease in type 2 diabetes : a systematic literature review of scientific evidence from across the world in 2007 – 2017. Cardiovascular Diabetology, 1–19. https://doi.org/10.1186/s12933-018-0728-6
Fahal, I. H. (2013). Uraemic sarcopenia : aetiology and implications. Oxford University Press.
Fivez, T., Hendrickx, A., Van Herpe, T., Vlasselaers, D., Desmet, L., Van Den Berghe, G., & Mesotten, D. (2016). An Analysis of Reliability and Accuracy of Muscle Thickness Ultrasonography in Critically Ill Children and Adults. Journal of Parenteral and Enteral Nutrition, 40(7), 944–949. https://doi.org/10.1177/0148607115575033
Ganbat, U., Byambaa, A. O., Tang, P., Feldman, B., Arishenkoff, S., Meneilly, G., & Madden, K. (2025). Quadriceps muscle thickness as measured by point-of-care ultrasound is associated with hospital length of stay among hospitalised older patients. Age and Ageing, 54(4), 1–8. https://doi.org/10.1093/ageing/afaf103
Ganbat, U., Feldman, B., Arishenkoff, S., Meneilly, G., & Madden, K. (2023). Associations Between Gait Measures and Quadriceps Muscle Thickness As Measured By Point-of-Care Ultrasound. Innovation in Aging, 7(Supplement_1), 910–910. https://doi.org/10.1093/geroni/igad104.2927
Guerreiro, A. C., Tonelli, A. C., Orzechowski, R., Corte, R. R. D., Moriguchi, E. H., & Mello, R. B. de. (2017). Bedside Ultrasound of Quadriceps to Predict Rehospitalization and Functional Decline in Hospitalized Elders. Frontiers in Medicine, 4(July). https://doi.org/10.3389/fmed.2017.00122
Hairi, N. N., Cumming, R. G., Naganathan, V., Handelsman, D. J., Le Couteur, D. G., Creasey, H., Waite, L. M., Seibel, M. J., & Sambrook, P. N. (2010). Loss of muscle strength, mass (sarcopenia), and quality (specific force) and its relationship with functional limitation and physical disability: The concord health and ageing in men project. Journal of the American Geriatrics Society, 58(11), 2055–2062. https://doi.org/10.1111/j.1532-5415.2010.03145.x
Mangner, N., Weikert, B., Scott Bowen, T., Sandri, M., Höllriegel, R., Erbs, S., Hambrecht, R., Schuler, G., Linke, A., Gielen, S., & Adams, V. (2015). Skeletal muscle alterations in chronic heart failure: Differential effects on quadriceps and diaphragm. Journal of Cachexia, Sarcopenia and Muscle, 6(4), 381–390. https://doi.org/10.1002/jcsm.12034
Maynard-Paquette, A. C., Poirier, C., Chartrand-Lefebvre, C., & Dubé, B. P. (2020). Ultrasound evaluation of the quadriceps muscle contractile index in patients with stable chronic obstructive pulmonary disease: Relationships with clinical symptoms, disease severity and diaphragm contractility. International Journal of COPD, 15, 79–88. https://doi.org/10.2147/COPD.S222945
Mehmet, H., Yang, A. W. H., & Robinson, S. R. (2020). Measurement of hand grip strength in the elderly: A scoping review with recommendations. Journal of Bodywork and Movement Therapies, 24(1), 235–243. https://doi.org/10.1016/j.jbmt.2019.05.029
Mesinovic, J., Zengin, A., De Courten, B., Ebeling, P. R., & Scott, D. (2019). Sarcopenia and type 2 diabetes mellitus: A bidirectional relationship. Diabetes, Metabolic Syndrome and Obesity, 12, 1057–1072. https://doi.org/10.2147/DMSO.S186600
Mohanasundaram, E. F. S. (2022). Uremic Sarcopenia. Indian Journal of Nephrology, 32, 399–405. https://doi.org/10.4103/ijn.ijn
Pardo, E., El Behi, H., Boizeau, P., Verdonk, F., Alberti, C., & Lescot, T. (2018). Reliability of ultrasound measurements of quadriceps muscle thickness in critically ill patients. BMC Anesthesiology, 18(1), 1–8. https://doi.org/10.1186/s12871-018-0647-9
Park, S., Park, S., Lee, J., Choi, Y., Kang, D. O., Park, E. J., Choi, J. Y., Roh, S., Lee, D., Na, J. O., Kim, J. W., Kim, E. J., Rha, S., Park, C. G., & Choi, C. U. (2025). Association of Handgrip Strength With Readmission , Mortality , and Exercise Capacity in Patients With Heart Failure. Journal of Aging and Physical Activity, 33, 506–516.
Pereira, A. S. et al. (2018). Metodologia da pesquisa científica. [free ebook]. Santa Maria. Editora da UFSM.
Purnamasari, D., Tetrasiwi, E. N., Kartiko, G. J., Astrella, C., Husam, K., & Laksmi, P. W. (2022). Sarcopenia and Chronic Complications of Type 2 Diabetes Mellitus. The Review of Diabetic Studies, 18(3), 157–165.
Rao, N. S., Chandra, A., Saran, S., & Lohiya, A. (2022). Ultrasound for thigh muscle thickness is a valuable tool in the diagnosis of sarcopenia in Indian patients with predialysis chronic kidney disease. Osteoporosis and Sarcopenia, 8(2), 80–85. https://doi.org/10.1016/j.afos.2022.06.001
Saito, H., Fujimoto, Y., Matsue, Y., Yoshioka, K., Maekawa, E., Kamiya, K., Toki, M., Iwata, K., Saito, K., Murata, A., Hayashida, A., Ako, J., Kitai, T., & Kagiyama, N. (2024). Ultrasound-measured Quadriceps Muscle Thickness and Mortality in Older Patients With Heart Failure. Canadian Journal of Cardiology, 40(12), 2555–2564. https://doi.org/10.1016/j.cjca.2024.09.007
Shitsuka, R. et al. (2014). Matemática fundamental para a tecnologia. (2ed). Editora Erica.
Su, Y., Yuki, M., & Otsuki, M. (2020). Prevalence of stroke-related sarcopenia: A systematic review and. Journal of Stroke and Cerebrovascular Diseases, 29(9). https://doi.org/10.1016/j.jstrokecerebrovasdis.2020.105092
Szwarcwald, C. L., Stopa, S. R., & Malta, D. C. (2022). Situação das principais doenças crônicas não transmissíveis e dos estilos de vida da população brasileira: Pesquisa Nacional de Saúde, 2013 e 2019. Cadernos de Saúde Pública, 38(suppl 1), 1–4. https://doi.org/10.1590/0102-311xpt276021
Vieira, S. (2021). Introdução à bioestatística. Ed.GEN/Guanabara Koogan.
Volaklis, K. A., Halle, M., & Meisinger, C. (2015). Muscular strength as a strong predictor of mortality: A narrative review. European Journal of Internal Medicine, 26(5), 303–310. https://doi.org/10.1016/j.ejim.2015.04.013
Wang, Y., Pu, X., Xue, L., & Ye, J. (2023). Handgrip strength and the prognosis of patients with heart failure : A meta ‐ analysis. Clinical Cardiology, 46, 1173–1184. https://doi.org/10.1002/clc.24063
Weijs, P. J. M., Looijaard, W. G. P. M., Dekker, I. M., Stapel, S. N., Girbes, A. R., Straaten, H. M. O., & Beishuizen, A. (2014). Low skeletal muscle area is a risk factor for mortality in mechanically ventilated critically ill patients. Critical Care, 18(1), 1–7. https://doi.org/10.1186/cc13189
Yoshimura, Y., Wakabayashi, H., Bise, T., Nagano, F., Shimazu, S., Shiraishi, A., Yamaga, M., & Koga, H. (2019). Sarcopenia is associated with worse recovery of physical function and dysphagia and a lower rate of home discharge in Japanese hospitalized adults undergoing convalescent rehabilitation. Nutrition, 61, 111–118. https://doi.org/10.1016/j.nut.2018.11.005
Zhong, Y., Liu, X., & Lin, T. (2023). The Relationship between Muscle Ultrasound Parameters and Diabetic Peripheral Neuropathy among Patients with Type 2 Diabetes Mellitus: A Cross-Sectional Study. Journal of Diabetes Research, 2023. https://doi.org/10.1155/2023/8897065
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